A ‘decade of neglect’ by successive Conservative administrations has weakened the NHS to the point that it will not be able to tackle the backlog of care for 7 million people, a government-commissioned report has concluded.
The paper from the King’s Fund health think tank says years of the health service being denied funding and failing to address its growing workforce crisis have left it with too few staff, too little equipment and too many outdated buildings to perform the amount of surgery needed.
Poor public finances in the UK, health service staff suffering from burnout and a wave of NHS strikes this winter will also prevent ministers from delivering on key commitments to stamp out the usual long waits, according to the think tank.
The findings are particularly embarrassing for conservatives because the report was commissioned by the Department of Health and Social Care (DHSC) late last year. They criticize the impact on the NHS of the austerity program initiated by David Cameron in 2010 and continued by his successor, Theresa May.
The report contrasts unfavorably with the tactics used by the Labor governments of Tony Blair and Gordon Brown in the 2000s to address the horribly long waits for care they inherited in 1997.
“While Covid has certainly exacerbated the NHS and social care crisis, we are ultimately paying the price for a decade of neglect,” said King’s Fund chief executive Richard Murray.
“The sporadic injections of cash during the austerity years after 2010 were at best intended to cover [the service’s] daily running costs. This shortage of long-term investment has led to a health and care system crippled by a lack of staff and equipment and crumbling buildings. These critical challenges have been evident for years.
“The NHS in 2022 faces many of the same challenges it faced in 2000: unacceptable waiting times and service hampered by staff shortages. Added to this is now a crisis in the cost of living, social movements of staff and a context of weakness in the economy and public finances.
The report is based on the first in-depth academic research undertaken in the UK into measures ministers and NHS bosses can deploy to deal with situations such as those prevailing today, where huge numbers of patients are again facing long delays in accessing planned hospital care.
Its findings are based on a review of the evidence on waiting times and, in particular, interviews with 14 experts, including many key figures in Labour’s successful eradication of long waits.
One of the experts, none of whom are named, said: ‘We’ve basically had 10 years of controlled decline. It’s not a Covid problem. It is an austerity problem.
The report identifies Cameron’s decision to cut annual NHS budget increases from 3.6% of Labor to an average of just 1.5% as the main reason for the service’s loss of capacity. The service’s performance against a number of waiting time targets introduced by the Labor Party began to decline in 2015 and has deteriorated every year since.
The report comes days after the latest official figures showed the waiting list in England for non-emergency hospital care had reached a new record high of 7.2 million people. Of these, 410,983 had been waiting more than a year for treatment – such as hip or knee replacement surgery, cataract removal or hernia repair – which is expected to take a maximum of 18 weeks.
Leaders of Britain’s A&E doctors as well as bosses of NHS ambulance services in England have expressed grave concern over the number of patients who are injured, and even dying, as a direct result of waiting for an ambulance to arrive or to get into A&E or from there into a hospital bed.
The 81-page document will be released later this week. He says the lack of NHS resources, combined with the different political, financial and economic circumstances that apply today, means that the politically important promises made earlier this year in the “plan of elective recovery” of NHS England are held.
They included promises to end the two-year, 18-month and one-year waits by summer, next spring and 2025 respectively.
The government has pledged to invest £8billion in tackling the backlog and NHS England has set up dozens of community diagnostic centers to help speed up testing and treatment for patients.
In his response to the Guardian about the report, Blair criticized the five Tory administrations since Labor lost power in 2010 for deviating from the three strategies he used to stamp out the backlog – reform, investment and political focus. He said this change in approach had harmed the NHS’s ability to deliver care within set waiting times.
“These key elements were, and I still believe, essential to improving public services. Since Labor left power, every pillar of those principles has been weakened as far as our health service is concerned,” Blair said. “As the report states, waiting lists are now at their highest level since the introduction of the 18-week treatment referral measure in 2004, along with the collapse of emergency care. “
He also took aim at ministers’ repeated efforts to describe the huge waiting list for care – which already stood at 4.4 million when the pandemic hit in spring 2020 – as “the Covid backlog”. Blair said: “This is not the result of Covid, but chronic underinvestment and mismanagement exacerbated by Covid.”
He added: “The lessons of this [Labour government] period, which ended with levels of satisfaction with the NHS at record highs, remain the same because these are lessons in governance: the government and the Prime Minister are making it a priority, devoting time to it and energy; a policy is in place that is based on what works; and then there’s a relentless effort across government to ensure delivery.
Blair said the King’s Fund findings “must act as a political wake-up call to renew NHS reform efforts, give this reform the political direction and buy-in it needs and align it with the good strategic investment”.
The Department of Health and Social Care has been approached for comment.
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